Introduction Herpes Simplex Virus Type 2 (Hsv-2) Infections Are Associated With Increased Risk Of Hiv Transmission. We Determined Hsv-2 Prevalence, Incidence And Associated Risk Factors, Incidence Among Persons With Indeterminate. Results, And Prevalence of Hsv-2/Hiv Co-Infection Among Persons Aged (18–34 Years) And (16–17 Years) Enrolled In An Hiv Incidence Cohort Study In Western Kenya.

Methods Participants(n=1106; 846 Adults) Were Screened And If Hiv-1 Negative, Enrolled And Followed-Up Quarterly For One Year. Hsv-2 Was Assessed Using The Kalon Enzyme Immunoassay.Hsv-2 Incidence Was Calculated Among Hsv-2 Seronegative Participants And Those Indeterminate At Baseline. Logistic Regression Was Used To Estimate The Odds Of Hsv-2 Infection and Poisson Regression Assessed Hsv-2 Incidence And Associated Factors.

Results Hsv-2 Prevalence Was 26.6% [95% Confidence Interval (Ci):23.9–29.4] And Higher In Adults (31.5%[95% Ci:28.3–34.9]) Than Adolescents (10.7% [95%Ci:7.1 15.3]). Factors Associated With Prevalent Hsv-2, Female Gender, Increasing Age, Hiv Infection, History Of Sexually Transmitted Infection, Low Education Level, Multiple Sexual Partners, And Being Married, Divorced, Separated Or Widowed. Overall Hsv-2 Incidence Was 4.0/100 Person-Years (/100py)95% Ci:2.7–6.1 And Higher In Adults (4.5/100py) And Females (5.1/100py).In Multivariable Analysis Marital Status Was Associated With Hsv-2 Incidence. Of 45 Participants With Indeterminate Hsv-2 Results At Baseline, 22seroconverted, Resulting In An Incidence Rate Of 53.2/100py[95% Ci:35.1–80.9]. Inclusion Of Indeterminate Results Almost Doubled The Overall Incidence Rate To 7.8/100py[95% Ci:5.9–10.5]. Prevalence Of Hiv/Hsv-2 Co-Infection Was Higher In Female Adults Than Female Adolescents (17.1 [95% Ci:13.6–21.0] Versus 3.4 [95% Ci:1.1–7.8]).

Conclusion High Incidence Rate Among Persons With Indeterminate Results Underscores The Public Health Concerns For Hsv-2 Spread And Underreporting Of The Hsv-2 Burden. Careful Consideration Is Needed When Interpreting Hsv-2 Serology Results In These Settings.